Postsecondary Education Services and Support (PESS)

Initial and Renewal Application

Here are a few things you need to know before you complete this application:

What is PESS?Postsecondary Education Services and Support (PESS) is a program for eligible youth and young adults currently and formerlyin foster care that provides a monthly financial stipend to assist the student in meeting the costs of attending a Florida Bright Futures-eligible postsecondary educational institution.

If the school you are attending is NOT a Florida Bright Futures-Eligible School, you may be eligible to receive a monthly ETV stipend.

What is ETV?Education and Training Voucher (ETV)is a federal program for eligible youth and young adults currently and formerly in foster care that provides a financial stipend that can be used to assist the student in meeting the costs of attending a non-Florida Bright Futures-eligible postsecondary educational institution.

What happens after I complete this application?

A decision will be made within 10 business days of the date you submit this application to your case manager or other designated staff.

If your application has been approved, your case manager or other designated staff will discuss the program requirements and your ongoing responsibility to meet the program requirements to remain eligible for a stipend, such as:

▪Submit enrollment and course schedule information, as required;

▪Maintain academic progress;

▪Complete the number of required hours each semester or grading period;

▪Notify your case manager of any changes in your education program or course schedule;

▪Notify your case manager of any changes to your address or contact information;

▪Submit grades and course completion information, as required;

▪Submit a renewal application every year in order to continue your stipend.

You will also receive information from your case manager or other designated staff about the amount of your monthly stipend, the date you will begin to receive a stipend and any additional eligibility requirements.

If your application is denied, you will receive a notice stating why you are not eligible to receive benefits, and information on how to appeal this decision should you choose to do so. You will also receive information about other services that may be available to you, including Extended Foster Care, funding through Education and Training Vouchers, Aftercare Services, and services that are locally available.

If additional information is needed, you will be advised of the supporting documentation you must provide. You will have 10 business days to provide the supporting documentation.

Name: (Please Print)______Date of Birth: _____/____/_____

Contact Information:

Address: ______

Telephone #: ______Email Address: ______

Text# or Facebook (if applicable): ______

Alternate Contact:

Name: ______

Relationship to Applicant: ______

Telephone #: ______Email Address: ______

State and County where dependency court was held when you were in foster care:

State: ______County: ______

Are you currently a Florida resident? Yes _____ No _____

Have you earned a standard high school diploma or its equivalent? Yes _____ No _____

If yes, what is the date you earned a high school diploma or its equivalent? _____/_____/_____

The name and contact information for the school, educational program, or other program that issued your diploma, GED or equivalent: ______

______

I am enrolled full-time (at least 9 credit hours) in a postsecondary educational institution that:

_____ IS a Bright Futures-eligible school.(

_____ IS NOT Bright Futures-eligible.

Name of the Postsecondary Educational Institution you are attending or planning to attend:

______

I have completed a Free Application for Federal Student Aid (FAFSA): Yes _____ No _____

If yes, what is the date you submitted the FAFSA? _____/_____/_____

Your current academic level:

Vocational School _____ College Freshman _____ College Sophomore _____

College Junior _____ College Senior _____ Other: _____

Are you requesting an accommodation for a disability? Yes _____ No _____

If yes, provide information about the disability and the type of accommodation you are requesting:

______

______

______

Are you applying for a renewal of PESS?Yes _____ No _____

If yes, have you maintained standards of academic progress as defined by your current postsecondary educational institution? Yes _____ No _____

Documentation: Please hand-deliver or scan and email a copy of the following documents to your case manager or other designated staff. Notify your case manager or other designated staff if you need assistance in getting copies of these documents.

1. Standard High School Diploma, GED or equivalent.

2. Class scheduleif you are currently attending a Bright Futures-eligible postsecondary educational institution OR admissions letter to a Bright Futures-eligible postsecondary educational institution.

3.If you are requesting an accommodation for a disability, please provide both of the following documents:

Documentation of a disability that prevents you from maintaining the minimum enrollment of 9 credit hours or the vocational school equivalent of full-time attendance; AND

4. If you are applying for a renewal of PESS, please provide a copy of all report cards (or equivalent) you have received since your last application.

I understand that as part of participation in the PESS program, I am consenting that the Department, my case manager or other designated staff will have access to my educational records. I have signed a separate release for each educational institution so staff can verify my enrollment and academic progress.

Please sign your initials _____

Applicant’s signature: ______

Date: _____/_____/_____

To be completed by the Case Manager:

Case Manager’s Contact Information:

Name: (Please Print) ______

Agency: ______

Address: ______

Telephone #: ______Email Address: ______

Case Manager: Document receipt of the application, ensure the section for your contact information is completed, and provide a copy of the application to the applicant.

This application was received:

In person _____ Via email _____ Postal or other mail delivery _____

Date application received: _____/_____/_____

Case Manager’s signature: ______

To be completed by Case Manager for the Young Adult’s file

This application IS complete, and the applicant will receive a decision on this application no later than: _____/_____/_____.

This application IS NOT complete and the applicant will receive information on the outstanding items no later than: _____/_____/_____. The outstanding items are: ______

Eligibility Determination:

___ Young adult meets all eligibility criteria for PESS.

___ Young adult does NOT meet all eligibility criteria for PESS.

Note: If the young adult is ineligible for PESS due to lack of attendance at a Bright Futures-eligible institution, the young adult may still be eligible for Education and Training Voucher (ETV) support. Use the information below to determine whether the youth/young adult is eligible for ETV support.

ETV ELIGIBILITY REQUIREMENTS

 Must be a current or former foster student who:

•was in foster care on his/her 18th birthday and aged out at that time.

OR

•was adopted from foster care with the adoption finalized AFTER his/her 16th birthday.

OR

•will have his/her foster care case closed between the ages of 18 and 21.

 Must be a U.S. citizen or qualified non-citizen.

 Must be at least 17 but younger than 21 to apply for the first time. Reapplication for ETV funds, if the youth/young adult has a current grant, may occur up to the age of 23.

 Must have been accepted into or be enrolled in a degree, certificate or other accredited program at a college, university, technical, vocational school. To remain eligible for ETV funding, the student must show progress toward a degree or certificate.

To be completed by the Case Manager in Consultation with the Young Adult

This information is required by federal statute to access funding through ETV.

To be completed by the Supervisor:

_____This application is Approved.

_____This application is Denied. Reason for denial: ______

______

______

______

Supervisor’s Signature: ______

Date: _____/_____/_____

NOTICE OF INSUFFICIENT DOCUMENTATION

______/____/______

Name of Young AdultDate of Birth

______/____/______

Name of Case Manager or Signature Date

Designated Staff (Print)

______

AddressCityStateZip Code

______

Phone Email

More documentation is required to process your application for Postsecondary Education Services and Support (PESS). Please provide your case manager or designated staff the following information within 10 business days: ______

If you do not provide the required documentation, your application will be denied; however, you can reapply as soon as you gather the documentation.

[A copy of this signed form shall be provided to the young adult by the case manager/designated staff.]

To be completed by the case manager or designated staff and placed in the young adult’s case file.

______/____/______

Name of Young AdultDate of Birth

______/____/______

Name of Case Manager or Signature Date

Designated Staff (Print)

_____ The documentation requested in the Notice of Insufficient Documentation was provided within 10 business days of receipt of the Notice.

_____ The documentation requested in the Notice of Insufficient Documentation was not provided within 10 business days of receipt of the Notice.

CF-FSP 5382, January 2015

65C-42.002, F.A.C.Page 1 of 9